Ellingsen O, Holthe M R, Svindland A, Aksnes G, Sejersted O M, Ilebekk A
Department of Cardiology, University of Oslo, Ullevål Hospital, Norway.
Eur Heart J. 1994 Sep;15(9):1184-90. doi: 10.1093/oxfordjournals.eurheartj.a060651.
Several studies have associated myocardial dysfunction with reduced myocardial Na,K-pump concentration, but whether impaired Na,K-pump capacity is a pathogenetic factor or an epiphenomenon related to accompanying cardiac hypertrophy is not established. We measured Na,K-pump concentrations in 10 hypertrophied and 11 normal weighted hearts obtained at autopsy using [3H]ouabain as ligand. Specific [3H] ouabain binding site concentration (OBC) in the left ventricle (LV) averaged 449 +/- 40 (pmol.g-1 wet weight; mean +/- SEM) in hypertrophied and 598 +/- 36 in normal weighted ventricles (P = 0.02). A trend towards lower LV OBC (-19%; P = 0.25) was found in hypertrophied hearts from patients with congestive heart failure as compared with non-failing hypertrophied hearts. In multivariate analysis with 18 variables including age and heart failure, only LV weight correlated independently with LV OBC (r = -0.61; P = 0.003). When OBC was related to either dry weight or to protein content, a 25-35% reduction was consistently found in hypertrophied LV, whereas RV OBC was similar in both groups. In conclusion, myocardial Na,K-pump concentration and thus the capacity to maintain homeostasis is reduced in LV, but not in RV, of hypertrophied hearts. Whether the moderately reduced myocardial Na,K-pump concentration is a pathogenetic factor in LV dysfunction remains to be determined.
多项研究已将心肌功能障碍与心肌钠钾泵浓度降低联系起来，但钠钾泵功能受损是致病因素还是与伴随的心肌肥厚相关的一种现象尚未明确。我们使用[³H]哇巴因作为配体，测量了10个肥厚心脏和11个正常重量心脏尸检时的钠钾泵浓度。肥厚心脏左心室（LV）的特异性[³H]哇巴因结合位点浓度（OBC）平均为449±40（pmol·g⁻¹湿重；均值±标准误），正常重量心室为598±36（P = 0.02）。与无心力衰竭的肥厚心脏相比，充血性心力衰竭患者的肥厚心脏中左心室OBC有降低趋势（-19%；P = 0.25）。在包括年龄和心力衰竭在内的18个变量的多变量分析中，只有左心室重量与左心室OBC独立相关（r = -0.61；P = 0.003）。当OBC与干重或蛋白质含量相关时，肥厚左心室中始终发现降低25 - 35%，而两组右心室OBC相似。总之，肥厚心脏的左心室中，心肌钠钾泵浓度以及维持内环境稳态的能力降低，而右心室则不然。心肌钠钾泵浓度适度降低是否是左心室功能障碍的致病因素仍有待确定。
